Embodiments described herein generally relate to an apparatus and a method for suspending an organ, a tissue, or other part of a body, such as a human body. More specifically, to correct organ prolapse, such as vaginal vault prolapse, the embodiments described herein enable a vaginal sacral colpopexy operation performed by a transvaginal approach which substantially reduces the need to invade the intraperitoneal space.
Abdominal sacral colpopexy (ASC) is widely recognized as the “gold standard” of all operations to restore vaginal suspension. Traditionally, sacral colpopexy has been performed through an abdominal incision. There are some accomplished laparoscopic surgeons who are able to do this procedure laparoscopically, however, doing this may be difficult for many surgeons. With the introduction of a robot in laparoscopic surgery, these surgical procedures may become more commonplace. However, use of a robot is rather expensive and may be time consuming.
There are a large number of surgeons that advocate vaginal surgery using a growing number of surgical procedures and devices that suspend the vagina to the uterosacral or sacrospinous ligaments. The advantage of these procedures is that vaginal surgery, in general, is easier for the patient to recover from and often has lower operative morbidity than the abdominal operations.
If a sacral colpopexy operation can be performed using a transvaginal technique that does not deviate from the optimal abdominal technique, then advantages of being able to offer the gold standard operation will be enhanced by avoiding unattractive aspects of abdominal surgery. In addition, if a sacral colpopexy operation can be done in a fashion that is technically safe and easy, then many surgeons may incorporate a sacral colpopexy into their standard practice.
One of the technical challenges of a vaginal sacral colpopexy is creating a correct operative plane between the vagina and bladder anteriorly and between the vagina and rectum posteriorly. With recent vaginal techniques using graft material, these operative planes are created through vaginal incisions with the aid of hydrodissection. These planes are exactly the same as the operative planes used with ASC. The operative planes extend from the site of the vaginal incision up to and around the top of the vagina. From this point, there is only a distance of about 5 to about 10 centimeters to the sacral promontory. Normally, sacral fixation points of ASC are in the body or the presacral fascia overlying the body of the vertebra at or just below the sacral promontory.
The sacral fixation points may be safely accessed with appropriate operating instruments that are passed into and through the vagina. A suspension graft may be attached at the identical sites where they would be attached using the standard ASC procedure, while avoiding invading the sacral blood vessels. In addition, installation of the graft may be accomplished more quickly with trans-vaginal sacral colpopexy than with ASC. While embodiments described herein do not specify the type of graft material to be used, it is anticipated that, in keeping with the goal of duplicating the ASC standard abdominal technique, a permanent synthetic mesh graft will be used. However, embodiments described here are not limited to this graft material and may be used to apply any type of biocompatible graft material having properties suitable for organ suspension.